Orthopaedic Surgery
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Browsing Orthopaedic Surgery by Subject "Ankle -- Radiography"
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- ItemThe Radiological Assessment to determine whether the use of assistive devices improve Syndesmotic screw placement during surgical fixation of ankle fractures(Stellenbosch : Stellenbosch University, 2022-07) Kriel, Renier; Ferreira, Nando; Burger, Marilize Cornelle; Faculty of Medicine and Health Sciences. Dept. of Surgical Sciences. Orthopaedic Surgery.ENGLISH ABSTRACT: Background: Ankle fractures are common injuries, and syndesmotic instability can pose a challenge to the inexperienced surgeon. This study aimed to investigate whether the aid of an assistive device as part of the standard of practice, namely the adapted technique, improves the accuracy of syndesmotic screw placement and reduction of the syndesmosis, compared to the traditional free-hand technique during the operative management of ankle fractures. Methods: This post-operative radiological assessment serves as a retrospective comparative series. Standard anterior-posterior radiographs were used to measure the height of the screw from the ankle joint line, and axial computed tomography slices at the level of the syndesmosis screw were used to measure the trajectory of screw placement against that of the ideal syndesmotic line, as well as the anterior and posterior syndesmotic spaces. Results: A total of 67 post-operative ankles were included (n=56 in the free-hand group vs n=11 in the adapted technique group). A difference between the height of screw placement was observed when comparing the historical free-hand technique to the adapted technique (p=0.002). No significant difference for the angle deviation or anterior- and posterior syndesmotic spaces was observed between the two groups. A trend (p=0.074) was observed with the free-hand technique associated with a larger deviation from the intended screw trajectory. Conclusion: Simple assistive devices may improve the accuracy of syndesmotic screw placement in terms of height and trajectory during the operative management of ankle fractures.